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Postoperative Bleeding, Revision Surgery, and Outcome of Cold Steel Tonsillotomy in Children With Upper Airway

Hanna Gerhardsson1,2, Joacim Stalfors3,4, Ola Sunnergren1,4,5

  • 1Department of Otorhinolaryngology, Jönköping, Sweden.

The Laryngoscope
|April 8, 2025
PubMed

Insights

Pediatric cold steel tonsillotomy with or without adenoidectomy (TT/TTA) is safe and effective for airway obstruction. Most patients reported significant symptom relief, with low rates of bleeding and revision surgery.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery

Background:

  • Upper airway obstruction in children is often caused by tonsil and adenoid hypertrophy.
  • Cold steel tonsillotomy with or without adenoidectomy (TT/TTA) is a common surgical intervention.

Purpose of the Study:

  • To evaluate the safety and clinical outcomes of pediatric cold steel TT/TTA.
  • Assessed bleeding rates, need for revision surgery, and patient-reported symptom relief.

Main Methods:

  • Retrospective cohort study of 1810 pediatric patients (≤18 years) undergoing cold steel TT/TTA.
  • Data collected from electronic medical records and the Swedish Quality Register of Tonsil Surgery.

Main Results:

  • A total of 2.0% bleeding events occurred, with 0.6% requiring surgical intervention.
  • The revision surgery rate was 5.1%, with younger age being a risk factor.
  • 94.4% of patients reported complete or almost complete symptom resolution at 6 months.

Conclusions:

  • Cold steel TT/TTA is a safe and efficient procedure for pediatric upper airway obstruction.
  • The study supports the efficacy of TT/TTA in improving patient symptoms and quality of life.
Abstract

Keywords:
cold steeloutcomepostoperative bleedingrevision surgerytonsillotomy

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